Individual
CRYSTAL M RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
6263 HONEY FARM WAY, GROVE CITY, OH 43123-3842
(518) 669-4302
Mailing address
6263 HONEY FARM WAY, GROVE CITY, OH 43123-3842
(518) 669-4302
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
I.2405792-SUPV
OH
1041C0700X
Clinical Social Worker
088102
NY
1041C0700X
Clinical Social Worker
SW20253
FL
Other
Enumeration date
11/20/2015
Last updated
12/06/2025
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